August Medicare Must-Knows

RetireMEDiQ strives to keep individuals informed about the latest Medicare news. Each month, we recap the top information consumers need to know about recent developments in the Medicare industry and how it may affect you.

Insulin Copays Capped at $35 Under Part D Senior Savings Model Caps

The Centers for Medicare and Medicaid Services (CMS) recently announced that this year’s Open Enrollment will include thousands of Medicare Advantage (MA) and Medicare Advantage Prescription Drug (MAPD) drug plans that offer lower insulin costs. Through a program called the Part D Senior Savings Model, beneficiaries will see a broad range of insulin copays capped at $35 for a one-month supply. According to CMS, “beneficiaries who use insulin and join a plan participating in the model could see average out-of-pocket savings of $446, or 66 percent.” In addition, next year’s Part D premium will continue the 2020 trend of being the lowest Part D premium since 2013. In 2021, the Part D premium will be $30.50, representing a decrease of 12 percent since 2017 and more than $1.9 billion in premium cost savings in the same amount of time.

Part D Plans Lean on Generic Medications to Help Seniors Save

A recent Health Affairs study out of Vanderbilt University Medical Center produced good news for Medicare Part D beneficiaries. The report explored the Part D formularies, or list of prescription drugs covered by an insurance plan, to see how many generic versions of prescription medications were included on a plan’s formulary compared to name-brand medications. The results of more than 1,360 pairs of medications showed that 0.9 percent of plans covered only the name-brand medication in 2019. In comparison, 84 percent of plans covered only the generic drug. About 15 percent of plans include coverage for both the name-brand and the generic prescription medications. According to a Medical Xpress article on the findings, the analysis covered a seven-year period from 2012 to 2019.

Innovative Responses to COVID-19: Nutritional Wellness

Across the country, Medicare Advantage (MA) providers and partners have created innovative ways to offer additional services to MA beneficiaries. Earlier this year, the Better Medicare Alliance issued a report called Spotlight on Innovation: The Response to COVID-19. This report showcased creative ways insurance companies, MA partners, and other senior-focused organizations have adjusted or added services to better support individuals during the COVID-19 pandemic. One such example was Meals on Wheels America, a Medicare Advantage Community Partner. Meals on Wheels was highlighted for its ability to serve meals safely to individuals, but also adjusted its delivery routines to offer safe, socially distant conversation with seniors who would otherwise be fully isolated. Similar examples of support for nutritional wellness can be seen in other partnerships, too. Just recently, WellCare, a private insurance provider, announced a partnership with Shipt, a grocery delivery service to offer free deliveries to Medicare Advantage beneficiaries. The partnership began in response to the COVID-19 pandemic which left some populations, including individuals over age 65, particularly vulnerable to the disease.

According to a press release issued by WellCare, “the partnership is part of WellCare’s continued commitment to address social determinants of health – non-medical barriers to care such as food insecurity or transportation assistance – all of which have been exacerbated by the coronavirus.” In response to these concerns, WellCare is providing free monthly Shipt memberships to low-income and special needs plan members in select WellCare, WellCare TexanPlus, and ‘Ohana Medicare Advantage Plans. These examples are just a small sample of the innovation we’re seeing from companies and organizations across the nation working hard to support Medicare beneficiaries.

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